LARYNX REMOVAL

General Information

DEFINITION--Removal of the larynx.

BODY PARTS INVOLVED--Larynx (voice box), organ at the top of the windpipe that controls the voice.

REASONS FOR SURGERY--Cancer of the larynx.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity; smoking; stress.
• Poor nutrition.
• Recent illness.
• Chronic illness, especially alcoholism.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Ear, nose and throat specialist (otolaryngologist).

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies.
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the neck. The muscles that attach the larynx to the windpipe are divided.
• The blood vessels and nerves that supply the larynx are located and cut.
• The larynx is cut free and removed with surrounding lymph node tissue (i.e., neck dissection) if indicated.
• A tracheostomy tube (device to prevent obstruction of air passage) is fitted and positioned.
• The muscles and skin edges are closed around the tube with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Inadvertent injury to the esophagus or trachea.

AVERAGE HOSPITAL STAY--5 to 7 days.

PROBABLE OUTCOME--Expect complete healing of the surgical wound. Allow about 4 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--

vein blood clots.

• Treat crusting and secretions around the surgical wound with petroleum jelly, antibiotic ointment and gauze. > A hard ridge should form along the incision. As it heals, the ridge will recede gradually. > Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. > Resume driving 2 weeks after returning home. > Rehabilitation may require learning new method for oral communication.

DIET---Tube or intravenous feedings for first 2 days after surgery. Then resume your normal diet gradually.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.